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Diagnosis and treatment of acute otitis media: evaluating the evidence

John H Powers1

  • 1Scientific Applications International Corporation in support of the Collaborative Clinical Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA. powersjohn@mail.nih.gov

Infectious Disease Clinics of North America
|June 15, 2007
PubMed

Insights

Acute otitis media (AOM) treatment guidelines offer limited strong evidence, with only pain management strongly supported. Further research is needed to clarify the benefits of antimicrobial agents for AOM.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Evidence-Based Medicine

Background:

  • Acute otitis media (AOM) is a frequent childhood illness leading to antimicrobial prescriptions.
  • Current AOM treatment guidelines offer six recommendations, but only pain management is strongly evidence-based.

Purpose of the Study:

  • To review AOM diagnosis and the accuracy of signs/symptoms for bacterial origin.
  • To evaluate antimicrobial efficacy versus placebo for AOM.
  • To identify knowledge gaps for future AOM research.

Main Methods:

  • Literature review of AOM diagnosis.
  • Analysis of studies on signs and symptoms indicating bacterial infection.
  • Review of clinical trial data comparing antimicrobials to placebo for AOM.

Main Results:

  • Strong evidence supports pain assessment and treatment with analgesics for AOM.
  • Limited strong evidence exists for other AOM treatment recommendations.
  • The accuracy of diagnostic signs and symptoms for bacterial AOM requires further investigation.

Conclusions:

  • Pain management is the only strongly evidence-based recommendation for AOM treatment.
  • More research is needed to establish the efficacy of antimicrobial agents for AOM.
  • Future trials should address current knowledge gaps in AOM diagnosis and treatment.

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